Hospitalization Study Fractures Science for Political Agenda

Isaac Orr is a policy fellow at the Center of the American Experiment on mining and energy issues and a former research fellow for The Heartland Institute. Orr is a speaker, researcher, and freelance writer specializing in hydraulic fracturing, agricultural, and environmental policy.

A recently released study claiming to have found a statistical association between hydraulic fracturing and hospitalization rates in Pennsylvania has been popular in the news. However, just about every aspect of this study is problematic, rendering it to the realm of speculation, not science.

The study claims chemicals used in the hydraulic fracturing process were “associated” with a number of ailments, such as heart, skin, and nervous system conditions, but the researchers never sampled the air or water in these areas to determine whether these chemicals were actually present. Similarly, the researchers could have measured levels of potential toxicants in people living at various distances from fracking sites and then tried to correlate those levels with health effects, but neither method was used.

If exposure to chemicals were to lead to any sort of negative health impact, it would more likely result in pulmonary (lung) disorders, but the study found no increases in pulmonary treatments. Additionally, drilling-site workers, not the general public, would be the most likely to experience any potential exposures and resultant effects.

Moreover, the authors limited the study to Pennsylvania residents. Why? Are local nonresidents somehow immune to the alleged effects the authors so aggressively cited or tried to establish?

Poverty is one of the greatest health risks people face, and up until 2008, Bradford County, Pennsylvania, suffered from one of the highest unemployment rates in the state, reaching 10 percent in 2009. According to the Food Research and Action Council, low-income people are especially vulnerable to obesity-related diseases, such as heart disorders and diabetes. They also suffer from limited access to health care resources. The study fails to consider these background factors affecting the health of residents in the three counties studied.

Whereas poverty often results in people not getting the health care they need, economic prosperity is strongly correlated with individual and community health. As a result of hydraulic fracturing and the resulting boom in natural gas production, Bradford County has enjoyed one of the lowest unemployment rates in the state since approximately 2010, falling to just 3.5 percent in 2013.

With new, high-paying jobs, many more people in the county had health insurance, some for the first time ever, resulting in more people using insurance and receiving health treatments, procedures, and investigations that had been on hold. The new prosperity suddenly and dramatically increased health care use rates.

The study admits the precise cause of the increase in inpatient prevalence rates within specific medical categories remains “unknown,” but it failed to account for this important factor. The researchers were, by their own admission, “unable to account for increases in population of the area.” They stated, “Given that our modeling approach cannot account for within zip code demographic changes over the study period, it is possible that some increases were due to an increased influx of subjects to a zip code.”

Translation: We don’t know how much of the increased use of health care was attributable to a rise in population. That’s clearly not all they don’t know.

During the period of concern, the local emergency room utilization grew by some 30 percent, ultimately driving a dramatic expansion of the physical structure at Robert Packer Hospital, increasing the capacity of the hospital to treat critically ill residents and nonresidents. As of 2013, the related demand for inpatient rooms drove the addition of some 16 new inpatient beds at RPH, a 6.7 percent increase. It is not at all surprising the authors of this highly refutable study, which bracketed the years 2007–11, saw these “trends carry through 2013.”

Additionally, RPH is a mecca for cardiac cases, repeatedly receiving high honors and being included among the 10-100 best cardiac centers in the state and/or the United States, according to accrediting and evaluating agencies. People from the entire region flock here for cardiac care. This, coupled with more people having greater financial access to healthcare resources, reasonably explains the increase in cardiac treatments in the county independent of any hydraulic fracturing operations.

The study estimated a 27 percent increase in hospitalizations for heart conditions compared with areas without any drilling, but heart conditions are influenced by a variety of factors, such as diet, weight, amount of exercise, and use of tobacco and alcohol. The study failed to take any of those factors into account, a huge oversight given that the area in question suffers from a smoking rate of about 33 percent, a significant obesity rate, and high alcohol- and illicit-drug-use rates. The health problems related to these factors increased in both incidence and prevalence during the period in question.

Finally, the authors buried an interesting fact in the study: “In our analysis, one particular zip code had extremely high inpatient prevalence rates compared to other zip codes. Thus, a sensitivity analysis was performed (data not shown). This zip code is located within Wayne County and had no active wells from 2007 to 2011” (emphasis added). The authors, inexplicably, removed “this zip code from the analysis.” The facts evidently did not suit the authors’ agenda here.

It is entirely understandable people would be curious or concerned about the potential health effects of hydraulic fracturing in their communities, but the data-dredging and obvious statistical manipulation deployed in this “study” should be recognized for what they are: advocacy, not epidemiology.

Dr. Theodore F. Them is a specialist in environmental medicine working at Guthrie, the 19th largest health care system in the United States. Isaac Orr (iorr@heartland.org) is a research fellow for energy and environmental policy at The Heartland Institute. Follow him on Twitter @thefrackingguy.